Digestive Health: Why Am I Bloated?

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Reviewed on 9/13/2017

What Is Bloating?

Distended abdomen, feeling like you ate too much, feeling like you are full of excessive gas. What causes these symptoms? There are many reasons for a swollen belly that feels too full. Several health conditions including irritable bowel syndrome, acid reflux, and celiac disease may cause it. Certain foods and beverages may also lead to the uncomfortable symptom. Often, bloating is not a cause for concern. Other times it may be a sign of something potentially more serious. The underlying causes of bloating are varied. Read on to discover what may be causing your symptoms.

What Causes Excess Gas?

Many people who feel as though they have excess gas may have increased levels or just an increased sensitivity to it in the gastrointestinal tract. Passing gas, bloating, burping, and belly pain and discomfort are common sensations in those who feel like they have excess gas. These symptoms may be due to a variety of conditions. Health problems including small intestinal bacterial overgrowth (SIBO), gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), and difficulty digesting certain types of carbohydrates may all contribute to gas build up. Other conditions like abdominal hernias, masses in the GI tract, abdominal adhesions, and dumping syndrome can affect the way gas moves through the intestines.

Skip the Salt

It Can Increase Symptoms

Where salt goes, fluid follows. Everyone needs some amount of sodium in their diet because it is a critical electrolyte in the body, but too much salt is detrimental to health and can make you bloat. Do not add extra salt when you prepare meals. Most people get more than the maximum recommended amount of sodium every day, the majority of which comes from foods that are processed or from a restaurant. Excess sodium increases the risk of high blood pressure, which puts you at risk for cardiovascular events like heart attack and stroke. The Dietary Guidelines for Americans recommends that adults consume no more than 2,300 milligrams of sodium per day.

Eat in Moderation

Overeating Makes You Bloat

Your stomach is approximately the same size as your fist and it stretches when you eat. If you overindulge, you will feel uncomfortable and bloated. Avoid stomach bloating by pacing yourself at mealtime. If you need some help, here are some tricks. Use smaller plates to encourage yourself to stick to reasonable portion sizes. Chew thoroughly and really enjoy every bite. Avoid distractions like TV while you're eating. Enjoy meals at the dining room table with friends or family. Concentrate on your meal and pay attention to your body's signs that alert you when you are full.

Fizzy Drink Dangers

Carbonated drinks including soda, sparkling mineral water, champagne, beer, and seltzer are full of bubbles that can make you bloat. Drinking these beverages can lead to gas bubbles in your digestive tract. Belching can get some of it out, but gas that reaches your intestines will make you bloat. From here, the only way to expel it is through the anus. In addition to the carbonation, sodas are loaded with sugar that can provoke bloating. High fructose corn syrup and artificial sweeteners are especially bad, too. Drink flat water instead of carbonated drinks to cut down on belching.

Slow Down At Mealtime

Eating too fast is a common cause of abdominal bloating because it results in swallowed air. Once that air reaches the intestines, you may feel pain and be bloated. The stomach stretches as you eat and sends signals to the brain alerting you that you are full. However, it takes about 20 minutes for the stomach to alert the brain, so you could be overeating and swallowing lots of air before you feel uncomfortably full. Slow down, chew thoroughly, and enjoy your meals. Drink enough water and stay hydrated to help ensure healthy digestion.

Constipation

Irregularity Causes Symptoms

If you miss a bowel movement or are irregular, you may feel bloated. Certain foods may contribute to constipation. If you struggle with irregularity, cut back on dairy products like ice cream and cheese, fast food, meat, and foods that are processed, prepared, fried, or high in fat. A diet low in fiber can trigger constipation. Not drinking enough water, stress, and dietary changes can lead to constipation, too. Drink more water, get some exercise, and add fiber to your diet to help get things moving again. Over-the-counter medications can help with an occasional bout of constipation, but long-term reliance on these medications is not a good idea and may signal an underlying health issue that needs medical evaluation.

Lactose Intolerance

Some people cannot digest a sugar in dairy products called lactose. Lactose intolerance leads to gastrointestinal symptoms like gas, bloating, diarrhea, and abdominal pain. Some people who have the condition may be able to indulge in milk, cheese, yogurt, and ice cream as long as they take a digestive enzyme that aids in the breakdown of lactose beforehand. Others do best by avoiding dairy products altogether. Inability to break down lactose is not the same as a dairy allergy. Symptoms of dairy allergy may include vomiting, hives, and even bloody stools.

Weight Gain

Weight gain, especially around the abdomen, can make you feel bloated. Excess weight puts pressure on your stomach, giving it less room to stretch at mealtime. If you are overweight or obese, ask your doctor to help design a weight loss plan that incorporates healthy eating and physical activity to shed pounds. The doctor may recommend eating a low-fat, reduced-calorie diet to shed pounds. Excess weight around the abdomen also ups the risk of gastroesophageal reflux disease (GERD), a disorder that causes burning stomach acid to back up into the esophagus.

Fructose Intolerance

This sugar occurs naturally in garlic, onions, honey, and certain kinds of fruits like cherries, apples, mangoes, pears, and watermelon. A form called high-fructose corn syrup is a sweetener found in many foods and beverages. People who do not tolerate the sugar will get a bloated stomach and will feel gassy and have abdominal pain or diarrhea after ingesting it. If you're not sure whether or not you tolerate the sugar, keep a food diary logging what you eat and drink as well as your symptoms. You will notice patterns that will tell you which foods and drinks provoke discomfort.

Be Mindful of Fats

Fat is a necessary macronutrient the body uses to insulate nerves, make hormones, and build cell structure. Excess fat is a problem because it takes a long time to break down and may cause digestive discomfort and stomach bloating. Ingesting too much may also lead to weight gain. If pounds gained end up around your abdomen, you may have additional pressure and discomfort in your midsection. Moderate your intake of fatty foods and watch your waistline to minimize bloat.

Menstrual Symptoms

Hormones Play a Role

Premenstrual syndrome (PMS) results in fatigue, irritability, and aches and pains the week prior to a woman's period. It also causes fluid retention which can feel like a bloated stomach. Hormones are likely responsible for the change in fluid balance during a woman's period. Even though a woman may crave salty or sugary snacks during her period, she should avoid these as they increase fluid retention. Exercise can also decrease pain and bloating.

FODMAPs

Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are small carbohydrates and sugar alcohols that are found in certain foods. Fructose, galacto-oligosaccharides (GOS), fructans, lactose, mannitol, and sorbitol are FODMAPs. Bacteria located in the end of the small intestine break down these carbs. People who are intolerant of FODMAPs may experience abdominal pain, bloating, excessive gas, and fluid retention after consuming foods that contain them. Garlic, asparagus, pears, peaches, mangoes, rye bread, and wheat pasta all contain FODMAPs. Keep track of what you eat and your symptoms in a food diary to identify things that may be problematic for you.

Celiac Disease

Gluten is a protein that is found in certain grains including wheat, rye, and barley. Some people develop an immune reaction against gluten and this in turn leads to damage to the lining of the intestine. People who have this condition, known as celiac disease, may experience abdominal pain, diarrhea, weight loss, gas, and bloating. Damage to the intestinal lining may affect digestion and the absorption of nutrients. People with untreated celiac disease may suffer from osteoporosis, infertility, migraines, intestinal cancer, and other serious health conditions. Celiac disease cannot be cured, but it can be managed by avoiding foods that contain gluten.

Is Bloating a Sign of Something More Serious?

Watch Out for Other Symptoms

Simple bloating is usually not a cause for concern, but it may be a warning sign of a more serious health condition in some cases. If you experience other symptoms, including diarrhea, nausea, fever, abdominal pain, weight loss, weakness, loss of appetite, or blood in the stool, see your doctor to rule out potentially more serious conditions. The doctor may order a stool sample or take images of your small intestine to assess for digestive problems and other conditions. Tests are available to check for lactose intolerance, celiac disease, ovarian cancer, liver disease, and other health problems.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the eMedicineHealth Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.